Diseases affecting kidney function are prevalent. For example, polycystic kidney disease (PKD) is a prevalent inherited disease. Adult PKD is an autosomal dominant disorder affecting approximately 600,000 people in the United States and 12.5 million world-wide. Infants can also present with autosomal recessive PKD which is rapidly developing and which can lead to renal insufficiency in the neonate. PKD and other kidney disease states (e.g., Dent's disease and nephrocytinosis) affect and manifest abnormal growth of kidney proximal tubule cells. PKD results in the proliferation of kidney epithelial cells and the formation of PKD renal cysts. The kidneys can become enlarged and symptoms including pain, bleeding, and kidney stones can occur. Associated problems include liver cysts, abdominal aneurysm, intracranial aneurysm, and renal insufficiency. It has been suggested that cellular processes associated with signal transduction, transcriptional regulation, and cell-cycle control are involved in cyst formation in PKD.
The folate receptor is a 38 KD GPI-anchored protein that binds the vitamin folic acid with high affinity (<1 nM). Following receptor binding, rapid endocytosis delivers a substantial fraction of the vitamins into the cell, where they are unloaded in an endosomal compartment at low pH. Importantly, covalent conjugation of small molecules, proteins, and even liposomes to folic acid does not block the vitamin's ability to bind the folate receptor, and therefore, folate-drug conjugates can readily be delivered to and can enter cells by receptor-mediated endocytosis. Because most cells use an unrelated reduced folate carrier to acquire the necessary folic acid, expression of the folate receptor is restricted to a few cell types, and normal tissues typically express low or nondetectable levels of the folate receptor. Folate receptors are overexpressed in proximal tubule cells.
The invention is based on the manifestation of abnormal proliferation of kidney proximal tubule cells in PKD and other kidney disease states that exhibit abnormal proximal tubule cell proliferation. These kidney disease states can be treated with ligands that bind to receptors overexpressed on proximal tubule cells wherein the ligands are complexed with an antigen, a cytotoxin, or a cell growth inhibitor for use in the treatment of the kidney disease states. These kidney disease states, including PKD, can also be diagnosed by using ligands that bind to receptors overexpressed on proximal tubule cells wherein the ligands are complexed with a diagnostic marker.